


between artifice and document

by cm14



Category: GOT7
Genre: Alternate Universe - Medical, Depression, Gen, Medical Acting, Mental Health Issues, Mentions of Suicide, Script Format, i'm experimenting w non-prose
Language: English
Status: Completed
Published: 2020-09-23
Updated: 2020-09-23
Packaged: 2021-03-08 01:01:04
Rating: General Audiences
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 1
Words: 3,955
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/26617117
Author URL: https://archiveofourown.org/users/cm14/pseuds/cm14
Summary: "A standardized patient is an actor trained to portray a real patient in order to simulate a set of medical symptoms or illnesses."Jinyoung acts. Youngjae bleeds.
Comments: 5
Kudos: 11





	between artifice and document

**Author's Note:**

> please do mind the tags.

**_SCRIPT (ACTOR’S COPY)  
_** **_Department: Psychiatry  
_ ** **_Case: Major Depressive Disorder_ **

**_LEE GYUHO  
_** _Psychiatry  
_ _Standardized Patient Training Materials_

**_CASE SUMMARY:_ **

_Lee Gyuho is a twenty-six year old male patient suffering from suicidal behavior brought about by undiagnosed major depressive disorder. The symptoms are as follows:_

  1. _Oversleeping_
  2. _Overwhelming feelings of shame and guilt_
  3. _Excessive alcohol consumption_
  4. _Suicidal ideation, obsession with scenarios surrounding death_
  5. _Overarching feeling of hollowness and emptiness_



_The depression started with a burnout from Lee’s office job that was left untreated. Lee has been out of work for two months since being fired for poor conduct and absenteeism- he did not show up to work for three weeks. Lee has a mother and a nineteen year old brother that depend on him. Being unable to support his family living in Mokpo has exacerbated the guilt and compounded the feelings of depression._

_Lee spends most of his days alone, in his studio apartment in Seoul. He doesn’t entertain visitors. Not his mother, not his friends, who regularly visit him out of concern. These days Lee doesn’t do much. His brother managed to bring him to an appointment._

_—_

The script is thick.

Jinyoung’s eyes scan the crisp paper once, then another time.

He didn’t really think taking the drama elective for two years in university would prove to be useful someday. But freelance writing means income is not always guaranteed. Breaking himself into the world of demand took two months- it was during that time that medical acting became a side gig of sorts. 

Not that Jinyoung considers himself particularly good at acting. Or that he’d call this a dream job. In the holding room for actors, he’s sat in between an elderly woman and a ratty-haired teenager. People with too much free time. But he gets paid 21,800 won per hour - somewhere along the lines of eighteen dollars. If he fills up enough applications, hunts for enough ads, it can pay the rent. Buy some pretty decent cuts of meat, even.

 _Gyuho, twenty six. A family in Mokpo, Jeolla. One brother, younger by seven years._ He hums to himself.

Jinyoung is twenty two. Jinyoung’s family is in Changwon, Gyeongsang. Jinyoung has two older sisters. Jinyoung and Gyuho have nothing in common.

_Suicidal behavior, brought about by untreated major depressive disorder._

Jinyoung is a medical actor, taking on the maladies of fictional characters for undergrads to diagnose and treat him. He’s what the script needs him to be. It tells him where it hurts, how it hurts, when to say it hurts. He’s contracted a life-threatening lung infection. He’s been the father of a blue-lipped baby. He’s gotten a Switch joycon stuck up his asshole. 

Really, he’d rather land a secure 9 to 5 at an editing firm. Copywriting sounds quite ideal. But Jinyoung can’t deny that acting is fun and gives him some inspiration for writing. The script has no qualms with being intimate. He’s had an uncle die in a car crash, which gave his father trauma, so he’s never ridden a car, which explains why he feels severe anxiety whenever he rides a vehicle. Of course, he’s to pretend he doesn’t know or understand what any of that has to do with his inability to ride a car without having a panic attack. His father's grief is a roll of film for the student to unfurl, hold under the red light of the darkroom as they dissect the memories of an uncle he never had and a funeral he never attended.

_Twenty six. Mokpo. A younger brother._

He thumbs the edge, turns the page.

—

**_MEDICATION HISTORY:_ **

_Lee is currently not on any medications. Lee has an allergy to aspirin._

**_MEDICAL HISTORY:_ **

_Lee broke his arm on his twenty-first birthday celebration after slipping on the poolside. Other than that, Lee has no significant medical history._

_—_

Youngjae stands up. He smiles nervously, then pushes his seat back.

“Thank you- um, thank you. For your time.” His voice quivers slightly as he extends his hand. Patient Lim purses her lips, gives the faintest hint of a smile as she shakes Youngjae’s hand. “Mhmm,” she purrs. Her footsteps make no noise as she exits the room.

Across the table, he looks to the two-way mirror. The lights turn on in the other room. His reflection disappears, giving way to his professor. Youngjae holds his breath.

“You need to work on making your patient feel comfortable. Small talk is an essential skill.” His professor frowns slightly. Unknowingly, he mirrors her facial expression.

“Body language, Choi. Don’t be nervous. As the doctor, you’re supposed to make the patient feel at ease.” She lets out a near imperceptible sigh.

“Well. The diagnosis was accurate, prescribed treatment was appropriate. All within thirty minutes. You did well.”

“Thank you, Professor,” Youngjae manages to barely breathe out.

“Take a break. Your next patient comes in fifteen minutes.”

He steps out of the room to get some water.

  
  


🏥

To treat a patient extends beyond metronomically listing off symptoms in the hopes of recognising the disease immediately. How do you teach compassion? How about empathy?

Perhaps one of the most crucial lessons Youngjae’s learned in his four years of med school is that medical interviewing is a craft. It’s knowing that there are questions whose answers need to be listened. Learning to tiptoe the line between caring and invasive. It's much more important than anything Youngjae'll ever learn from a textbook in his lifetime.

In his freshman year as a medical student, Youngjae’s communication training was more patient-centered. How to coax out the symptoms of a fever from a five year old, how to diagnose appendicitis from a simple stomach ache. As he progressed in university, the sessions increased in severity. Discussing end of life concerns with geriatric patients. Mental health assessments. Delivering the news of a stillbirth.

 _Empathy training,_ one might call it.

Youngjae takes a paper cup and presses a button on the cooler. The ice-cold water from the machine drips steadily.

The patient walks into the room, earnest, ready to pour their heart out. The doctor contractually cannot extend the same degree of sincerity towards the patient, bound to an oath of professionalism.

Express concern. Show care. Voice compassion.

The field of healthcare is fundamentally about empathy, and it's no coincidence that so is acting. The professional knows how to embody the suffering of their patient, but never enough so as to let emotions get into their heart. The same way a Shakespearean actor would evince the harrowing grief of Hamlet for three long hours, to wash it off the same time as he does his stage make-up. Medicine becomes a performance art just as much as it is a science.

Youngjae gets his cup. He stares at his warped reflection.

_Just me. Jae._

He's just as much of an actor as the simulation patients that sit in front of him. Youngjae knows that. Youngjae also knows being kind and being soft are two different things. Unfortunately for him, he’s always been the one with too delicate a heart. Sometimes he wonders whether he’s too tender to pursue musical therapy.

Youngjae walks back to the session room.

— 

**_PHYSICAL PRESENTATION AND TONE:_ **

_You are wearing a simple shirt and a pair of crumpled jeans, unironed. Little to no effort is required for your personal appearance. You are a man of few words. You try to act like you are keeping it together, and this is reflected by the iciness in your voice. Nevertheless, anxiety underpins the cool, almost flippant tone._

**_OPENING LINE:_ **

_“My brother brought me here. He thinks I might be depressed.”_

— 

“Park Jinyoung!” That’s his cue.

He gives a tight, polite smile to no one in particular. One of the actors nod at him. “Good luck, man.” He mumbles a “thank you” and ambles out the holding room. There’s a woman holding a clipboard waiting for him outside.

“For the simulated exam of Lee Gyuho?” He nods. “Third room to the right.”

Another mumbled thank you. He rolls his shoulders and walks down the hallway. Humming quietly, he reaches the door and stops in front of it. One knock, then another. Then he opens the door.

“Dr. Choi?” Jinyoung keeps his hand on the doorknob. He remembers to level his voice. The white coat turns around.

“Good afternoon. You must be Gyuho, Lee Gyuho?” Dr. Choi has a bright face and a warm smile- his presence is disarming. Jinyoung barely remembers to keep up his wintry facade.

“That’s me,” he replies curtly.

Youngjae sticks his hand out. What would Gyuho do?

Jinyoung sets up a deliberate moment of hesitation, then accepts the handshake. A short, firm wave. Then he makes a beeline for the seat.

“My name is Choi Youngjae. I'll be your psychiatrist for today. How can I help you?”

Jinyoung keeps his eyes trained on a blank notepad. “My brother brought me here. He thinks I might be depressed.”

“Is that so?” Youngjae picks up a pen. Jinyoung is almost certain about how this is going to go. He’s taken on cases of depression before. _Have you been eating? How’s your sleep quality?_ The students he’s encountered are aggressively methodical in their questioning. Ticking off boxes in a mental checklist, seemingly in a hurry to prescribe the escitalopram.

Instead, “You two must be close. How’s your relationship with your family?” The question takes Jinyoung by surprise.

“We’re not. There’s not much to talk about.”

“Do you see them a lot?”

“I don't.”

Youngjae pauses, as if gauging the dryness of his empty responses. “Why not? Does your family live far away?”

“Yes. I live alone.”

Maybe Gyuho’s impatient. Maybe he doesn’t want to be here. So Jinyoung starts tapping his foot on the floor. He’s good at this, reading between the lines. Always has been.

“It’s good that your brother scheduled this appointment for you. Having a social safety net really helps with the depression.”

“I wouldn’t say that. I don’t think I have… you know.” Jinyoung lets himself smile, albeit a bit testily.

To this, Youngjae smiles patiently. He changes the topic. ”Where’s the rest of your family?”

“In Mokpo, Jeolla. Where I grew up.”

“That’s my hometown!” Youngjae’s face breaks out into a lovely smile. _That’s a lot of teeth_ , Jinyoung mentally notes.

Youngjae puts down his pen, a wave of enthusiasm taking over him. “Where in Mokpo are you from?”

Fuck if Jinyoung knows the geography of Jeolla. 

This is beyond the extent of his script. He finds himself grappling for an answer. Meanwhile, Youngjae’s face is bright and expectant.

“Um… uh,” he says dumbly. Youngjae’s eyes are peering into his. Searching to establish some common ground.

“You know… near the port.” Jinyoung makes an aborted with his hand before folding his arms. “Geumhwa?” It almost comes out as a question. Thankfully, Youngjae doesn’t seem to notice.

“Oh, we grew up in opposite ends of the city. I lived in Sanjeong.” Youngjae picks his pen up again. “Don’t you miss Mokpo? Ever since I moved to Seoul to pursue medicine, I know I do.”

Jinyoung swallows hard. “Sure.”

Does Gyuho miss his hometown? How the hell is he supposed to know?

“I guess I miss... the sea. Um, squids.”

Youngjae closes his eyes for a moment. A serene smile takes over his face. “I know. The port of Mokpo is beautiful.”

Jinyoung’s no stranger to improvisation. In every encounter, the small talk is made-up, contrived. He’s been a fan of more sports teams than he can recall. He’s owned several pet dogs and aren’t they just cute. The simulation patient scripts are thick. He’s held up to twenty pages at a time and he finds himself constantly thinking about what the papers don't include. 

Every doctor-patient encounter is an act. Both of them take on characters, build a scene, bring the moment of improv to life. Yet Youngjae’s smile is beaming with sincerity. Gyuho is the one from Mokpo- not Jinyoung. Has he forgotten that they’re both pretending?

— 

**_ENCOUNTER DYNAMICS:_ **

_You are closed off and won’t reveal much about yourself, even when pried. A concrete wall of guilt and shame prevents you from seeking the help you know you need. You actively deny all possibilities of being depressed- though you have been out of work for a few months, you don’t want to admit to any possible signs of “weakness”. Deep down, however, you know there is a problem that needs treatment._

_Upon interrogation, all answers are terse, impersonal. You talk of your symptoms matter-of-factly, almost as if the pain is nonexistent. “The sky is blue, the trees are green, the ceiling is more than familiar with my deadweight.”_

_Your family is a contentious topic. So is your employment, or lack of. When asked about your job, deflect. When asked about your family, show signs of irritability or sensitivity. However, when the doctor asks about your mother, simulate the breakdown. Choke on silent tears. Ramble about the guilt of being unable to provide for your family and knowing that your mother has had to pick up a job again while you waste your savings on beer. After this, be more vulnerable and willing to talk about your day-to-day life._

_Once the circumstances surrounding your burnout have been uncovered, only then will you accept a diagnosis of depression._

— 

“It brings back a lot of pleasant memories,” Youngjae says quietly.

“Um, me too.” Jinyoung’s pained voice sounds less than interested now. Youngjae reminds himself he’s in a simulated exam and clears his throat.

"Your profile says you live in Seoul. It must be hard living alone in such a big city, then."

Almost as if on cue, his patient’s shoulders stiffen and he averts his gaze. "I manage."

Youngjae clears his throat and readies a notepad. "So, I understand your brother referred you here because he suspects you might be depressed. Can you describe how you feel on most days, then?”

Patient Gyuho shrugs. “Normal.”

 _This is getting nowhere fast,_ Youngjae thinks to himself. He’s diligent like no other. He’s studied hard for this, but how is he going to poke and prod open a stubborn clamfish of a patient? “What about your eating and sleeping habits?”

“I don’t know. Normal. I guess I sleep a lot.”

Finally, an opportunity to break in. “Can you tell me how much is a lot?” He’s met with another shrug. 

“I wake up at four in the afternoon. Sleep at twelve midnight… Something like that”

“That’s unusual. What about your job? Are you on a graveyard shift?” Youngjae finds himself unable to mask the pure curiosity in his voice.

His patient lets out a heavy, if distracted, sigh. “I don’t eat a lot. My brother said I’ve lost weight.”

Youngjae doesn't miss how Jinyoung just blatantly avoided answering him. That’s curious. He mentally files the previous question to bring up again later. “Do you drink or smoke?”

The patient lets slip the smallest of smiles. “Alcoholic.”

“Okay. What about drugs?” He shakes his head.

“I’ll be frank. We’re looking at a very unhealthy lifestyle and I’m inclined to suggest some changes.” Youngjae purses his lips as he reviews his scant notes. He’s met with nothing more than a nod, a dismissive “okay”.

“Your brother made sure to mention his worries over your suicidal behavior. Can you tell me more about that?”

“I attempted to hang myself some few months ago. He was the one who found me.”

The candid manner of speech stuns Youngjae for a few seconds. The voice of his professor echoes in his head. _Body language, Choi. Don’t be nervous._

_As the doctor, I’m supposed to make him feel at ease. Right._

He clears his throat again. “Right… okay. Right. That’s quite significant. Can you tell me what caused this?” And for the first time, Jinyoung looks Youngjae straight in the eyes. The iciness in his gaze sends a small chill down Youngjae’s spine.

Jinyoung only stares. He doesn’t answer.

“Was it a social problem? Or work related?”

Finally, Jinyoung’s steadfast eyes drop to the floor. Youngjae feels like he already has his answer. He tries once again, adding firmness to his tone.

“Was it a work related problem?”

“I got fired,” Jinyoung admits abruptly. Almost reflexively, Youngjae nods. Living in Seoul would be impossible without an office job.

“Why?”

“I was absent for a while.”

“So excessive absences led to your being fired, and you attempted suicide-”

“Shortly after. Maybe two weeks.”

It took him a while to get to this point, Youngjae thinks. But at least his notes are starting to take form. “Would you say you experienced any feelings of depression during those two weeks?”

“Shame. Guilt.” Followed by a shrug. Despite the weight of their current topic, Jinyoung’s eyes are flitting about the room. He seems laidback, almost.

“Shame towards whom?”

“Myself.” The answer comes easily.

“Okay. And guilt towards whom exactly? Your family?”

Jinyoung’s body stiffens once more. Youngjae doesn’t fail to notice how his patient’s eyes fix themselves on his mug all of a sudden. Unwilling to answer now.

“Would you say these feelings of guilt are addressed to your family, your mother maybe?” He flips the page of his notepad.

“Sorry.” 

Youngjae looks up. “W-what?”

“I feel sorry for my mother.” Jinyoung’s- Gyuho’s- voice starts wavering. “That she has to take care of someone like me.” A tear rolls down his cheek. Jinyoung’s face is stoic as ever, but the shakiness in his voice betrays his emotions. Once again, Youngjae is stunned into silence.

Simulated exams are nothing more than an invented encounter. Fiction brought to life with the help of its ambitious actors and medico-hopefuls attempting to inhabit its reality.

“I feel sorry for my brother. That I can’t support his education.” His breath stutters. “I’m supposed to take care of him. But I can’t even put food on their table. I live in fucking Seoul and I don’t think of anyone else, just myself, and I do whatever I want and my family’s suffering because of me.”

Nonetheless, there is a silent pact between both parties to respond with unaffected sincerity. Everything that is said in the room is true- or, at least, as true as it can get for the next thirty minutes. Because listening is a gift. So is empathy. And Youngjae's always been told that it’s more selfish than it is empathetic to embody someone else’s pain in its entirety. Still, he's eager to learn. If he's not naturally gifted in that aspect- fine. No doubt that with some diligence, he'll catch up. 

But he's always been the kid with the soft heart, hasn't he?

His chest constricts, his heart aches. In his own mawkish display of empathy, he’s taken in Gyuho’s pain as his.

_—_

**_Department: Psychiatry_ **

**_Case: Major Depressive Disorder_ **

**_POST EXAM_** **_ASSESSMENT_**

______ _ _Student was able to uncover relevant background information._

 ______ _ _Student was able to elicit crucial pieces of information._

 ______ _ _Student made the patient feel comfortable during the session._

 _______ _S_ _tudent was not invasive nor aggressive in their line of questioning._

_._

_._

_._

______ _ _Student was able to handle an emotional breakdown. (Rate only if applicable.)_

_._

_._

_._

_._

_._

______ _ _Student_ _voiced_ _empathy for the situation/problem._

**_Actor's notes/complaints:_ **

_—_

Jinyoung allows himself to mentally disappear into his script as he rattles out the rest of his simulated breakdown. He's nothing if not assiduous. Quiet and unassuming when he works, but constantly feeling the need to prove himself capable to anybody watching. His pride had brought him to practice this very part to perfection. He doesn't mind. Acting's always been a little bit fun. 

Distantly, he can feel his fists banging on the table. It’s a rather detached sensation, as if he’s merely witnessing his body and not actually controlling it. Jinyoung loses himself in the drama, fades in between the lines- until his eyes connect with Youngjae's. And his heart trips over itself and his tongue too trips over his sentence.

The slip wasn't noticeable, really. A moment's stutter over a few words. But Jinyoung draws a sharp breath in anyway. Under the white light of the fake clinic, the young student's dark eyes refuse to blanch, instead gleaming with sincerity. His eyebrows are drawn together. Youngjae's fully focused on Jinyoung, as if him and his made-up tale of woe were the only things that mattered right now, in this very moment. Jinyoung feels himself melt like a pat of butter under his warm gaze. 

Youngjae has a pack of tissue in his hand. Something tickles in his belly.

"Excuse me, I- Sorry. I'm sorry. What was I saying? Ah..." Jinyoung trails off. His mind is blanking and he's unsure of what to say next.

"You've said enough. It's okay." Youngjae pulls a few sheets of tissue from the packet and hands them to Jinyoung. Youngjae's fingers touch his palm. _Warm_ , he thinks. _Just like his eyes._

"You don't have to say anything else if you're uncomfortable." Youngjae offers a professional but sympathetic smile. _Warm, too,_ Jinyoung's mind finishes for him before he can stop himself. He brings the tissue to his cheeks before he can come up with any more ridiculous thoughts. Meanwhile Youngjae hasn't stopped looking at him.

"Let's take a few deep breaths. I'm going to count from one to five. Can you follow me?" The worry hasn't left Youngjae's eyes, but his tone is controlled and placating. "Let's inhale... one, two, three, four, five. That's it." 

His voice fills the room. Jinyoung's cried in front of strangers countless times before, it’s part of the job. But for some reason, he feels embarrassed now.

“I know the feeling.” Youngjae’s the first to break the silence.

“Hm?”

“Of having to take care of something. Someone,” Youngjae lets out a small smile while collating his notes. “Of course, I’m studying to become a doctor. So I guess I’d be a lot more familiar with that."

Jinyoung nods. He realizes this student's oo soft to ever make it in the medical industry.

"But you know, you have to take care of yourself before you can take care of other people. That’s what I’ve been told. And it’s true, isn’t it?” Jinyoung catches a flash of emotion incriminate itself through Youngjae’s eyes. “It’s a lot of pressure to take care of yourself though. Get it together, to help other people get it together."

"It's hard, isn't it?" Jinyoung blurts. He wasn't supposed to say anything.

"Self-care,” Youngjae breathes out. Sets down all his papers to one side. “Is a lot of things. None of them easy.” 

Jinyoung blinks.

“So, how are you feeling?”

“Sober," Jinyoung answers honestly. Answers as himself. Answers as Jinyoung Park.

Across him, Youngjae waits for more. Only belatedly does Jinyoung realise he's given up his character completely. He shuffles in his seat. “I mean… I haven’t cried in a while. You know how it is.” 

“Well,” Youngjae steeples his fingers. “I have a hunch that I certainly do. And we might both agree that it’s clinical depression compounded by burnout. I’ll write you up a prescription of escitalopram, we’ll start at the initial dose of five grams since it’s your first time on medication. Then you need to return to my clinic for another assessment.”

The words fly in and out of Jinyoung’s ears. He’s forgotten his script at this point, so he just nods. “'Kay. Sounds good.” Youngjae stands up, and Jinyoung follows.

“Dr. Choi… Youngjae, was it? Choi Youngjae?”

He startles to being referred to by his full name. “Yes, why?”

“Take care of yourself,” Jinyoung starts towards the door. Places his hand over the handle. “Your heart, especially. It’s delicate like glass.”

Youngjae doesn’t get to say anything- by the time the words have sunk in, his patient is gone.

**Author's Note:**

> heavily inspired by the empathy exams by leslie jamison. it's a very insightful essay and i liked it a lot, hence why i wrote this fic.
> 
> this is my first published fic! i know it's a bit experimental and weird, so thanks for reading to the end. please leave a comment or something!


End file.
